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Group Health Insurance Claim Short Settled

When a group health claim is short-settled, the insurer pays less than expected for medical expenses. At Authentic Insurance Brokers India Limited, we help review the claim and negotiate to secure the rightful reimbursement for your employees.

What Does a Short-Settled Group Health Insurance Claim Really Mean?

A short-settled Group Health Insurance claim means the insurer has paid less than the actual medical expenses claimed, often due to sub-limits, exclusions, room rent capping, or insufficient documentation. This can leave employees or employers to bear unexpected out-of-pocket costs, creating dissatisfaction and financial stress. At Authentic Insurance Brokers India Limited, we help employers and HR teams understand the reasons behind claim short-settlements, review policy terms, and coordinate with insurers to pursue a fair and justified settlement—ensuring your team receives the coverage they were promised.

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Sargam

Despite having Group Health Insurance, the insurer’s payout didn’t cover the actual hospital expenses, and we were left managing unexpected costs that should have been covered

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Ravindra

Even with group health coverage, the amount reimbursed was much lower than the hospital bills. We were left covering a gap we thought insurance would handle.

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Dharmendra

The insurer’s settlement on our group health claim was unclear and far lower than expected. We struggled to interpret the policy terms and didn’t know how to push back

FAQs

How does know your policy feature work ?

All you need to do is to fill in a few details and upload your policy. Our AI-enabled platform scans through your policy document, which will help you find missing information, errors, and inconsistencies in your policy.

Quality check will help you understand the problems associated with your insurance policy and give you a drafted email that you can send within seconds.

We enable you to send pre-drafted email to your insurance company to get your details updated & rectify the mistakes